Unknown Individual – Family Medicine Physician, NPI 1699778209

Unknown Individual is a healthcare provider. based in Hamilton, Illinois. specializing in Family Medicine Physician. They hold a License No. 22154 (IA). The NPI Number for Unknown Individual is 1699778209

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1699778209
Phone
(217) 847-2112
Address
951 BROADWAY ST
Deactivation Date
18 May 2021

Doctor Profile

Medical School Name
UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Secondary Phone
3195245734
Graduation Year
1979 (47 years ago)
PAC ID
6002871647
Group Practice PAC ID
4486562527
Professional Enrollment ID
I20041123000754
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Broadway Street, Webster City, Hamilton County, Iowa, 50595, United States

    HAMILTON, IL 623411436

    Phone: (217) 847-2112

    Fax: (217) 847-3813

    Type: Location

  • North 17th Street, Keokuk, Iowa, 52632, United States

    KEOKUK, IA 526323452

    Phone: (319) 524-5734

    Fax: (319) 524-5758

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62341)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486562527View full group profile
NameSpecialtyState
Nurse PractitionerIA
P S Y C H I A T R YMO
-IA
Clinical Social WorkerOR
Nurse PractitionerIA
Nurse PractitionerIA
Clinical Social WorkerIA
-MI
Internal Medicine, Emergency MedicineKS
Nurse PractitionerIA

Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1699778209.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Family Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Hamilton, Illinois for Unknown Individual; download NPPES for the complete set.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1699778209. Always confirm identity and privileges with the practice and licensing boards.

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